1548439326 NPI number — VIENER ORTHOPEDICS, P.A.

Table of content: (NPI 1548439326)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548439326 NPI number — VIENER ORTHOPEDICS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIENER ORTHOPEDICS, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548439326
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7350 VAN DUSEN RD
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
LAUREL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20707-5263
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-776-7000
Provider Business Mailing Address Fax Number:
301-498-5025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9501 OLD ANNAPOLIS RD
Provider Second Line Business Practice Location Address:
SUITE 308
Provider Business Practice Location Address City Name:
ELLICOTT CITY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21042-6314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-964-6496
Provider Business Practice Location Address Fax Number:
410-740-4470
Provider Enumeration Date:
02/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
VIENER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
STEPHEN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-776-7000

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  D22108 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 718L . This is a "MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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